title: Observational study of buprenorphine treatment of opioid-dependent pregnant women in a family medicine residency: reports on maternal and infant outcomes.
abstract: OBJECTIVE
  Within a family medicine residency, an outpatient buprenorphine treatment program was provided for pregnant women who were dependent on opioids. The purpose of this study was to investigate the outcomes of infants who were exposed to a range of doses of buprenorphine in utero and to determine how closely observed maternal/fetal outcomes (eg, method of delivery and infants requiring treatment for neonatal abstinence syndrome [NAS]) match those previously reported in the literature.
  
  
  METHODS
  This study consists of a retrospective case series of 23 infants born to 22 pregnant women who were dependent on opioids and who were treated with buprenorphine during a 31-month period.
  
  
  RESULTS
  Thirty-five percent of infants (8 of 23) required treatment for NAS. There was no significant relationship between maternal dose of buprenorphine and birth weight, NAS severity (ie, peak NAS score), or time to first peak NAS score. Infants born to tobacco users had a significantly lower birth weight (P = .0136) than infants born to nonusers. Seventy percent of infants (16 of 23) were breastfeeding at the time of discharge from the hospital.
  
  
  CONCLUSIONS
  The observations made in this case series are consistent with data previously reported in the literature. Infants in this study were more likely to be breastfed than those previously described by others, but further analysis is necessary to determine whether this finding is significant.
authors.affiliation: the Maine Dartmouth Family Medicine Residency, Augusta, ME 04330. aoconnor@mainegeneral.org
authors.forename: Alane
authors.initials: A
authors.lastname: O'Connor
authors.forename: William
authors.initials: W
authors.lastname: Alto
authors.forename: Katje
authors.initials: K
authors.lastname: Musgrave
authors.forename: Daniel
authors.initials: D
authors.lastname: Gibbons
authors.forename: Lalaine
authors.initials: L
authors.lastname: Llanto
authors.forename: Selma
authors.initials: S
authors.lastname: Holden
authors.forename: Jonathan
authors.initials: J
authors.lastname: Karnes
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use*; D005194:Family Practice; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007396:Internship and Residency; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009357:Neonatal Abstinence Syndrome / Q000517:prevention & control*; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009292:Narcotic Antagonists; D002047:Buprenorphine